Objective To explore the association between L-selectin gene P213S polymorphism and angina pectoris.Methods L-selectin gene P213S polymorphism in 138 patients with angina pectoris and 156 controls was detected by polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP).The relationship between gene polymorphism of L-selectin and levels of serum lipids were also studied.Results L-selectin genotype frequencies of PP,PS,SS were 60.1%,36.3%,3.6% and 44.9%,48.1%,7.0% in angina pectoris group and control group respectively.Allele frequencies of P,S were 78.3%,21.7% and 68.9%,31.1% in angina pectoris group and control group respectively.There was significant differences of frequencies of genotype and allele of L-selectin P213S polymorphism between angina pectoris group and control group(P

Objective To investigate the situation of medical waste management in medical institutions of Hubei Prov-ince,and put forward the improvement strategies.Methods The questionnaires were designed according to the relevant standards,situation of medical waste management in 75 hospitals in Hubei Province was investigated by stratified sampling, 73 available questionnaires were got.Results The construction of medical waste management software and hardware in 73 hospitals were basically met the requirements of the standards,the qualified rates in organization and system management, classification and disposal of medical waste in departments were all >90%;83.56% (61/73)of the hospitals carried out the best environmental practice(BEP)for medical waste;application of more than 40 kinds of disposable medical devices and supplies were reduced;76.71% (56/73)of hospitals’soft infusion bags were collected and recycled by designated company;only 21.54%(14/65)of hospitals send pathological chemical waste liquid to hazardous waste disposal center;disposal ways of orthopedic stainless steel plates were different,56.16% (41/73 )of hospitals treated plates as medical waste,only 35.62%(26/73)of hospitals informed patients how to deal with it,and signed informed consent with patients. Conclusion Medical waste management in medical institutions in Hubei Province has been paid more and more attention, but for special categories of medical waste disposal,such as soft infusion bags(bottles),orthopedic stainless steel plates, and pathological chemical waste liquid,there are some problems,training still needs to be strengthened,the classification and disposal of medical waste needs to be standardized further.

Objective To explore the effect of ATP fluorescence detection on on-site monitoring and supervision of healthcare-associated infection management .Methods ATP bioluminescence analyzer was used to detect the con-tamination status of hands of health care workers(HCWs),the object surfaces,and the cleaning tools in all quarters of 2015,the detection results were timely given feedback,and improvement measures were put forward.Results A total of 1 294 specimens were detected,the overall qualified rate was 62.75%.The qualified rates of hands of HC-Ws,object surfaces,and cleaning tools increased from 54.35%,50.30%,and 60.26% in the first quarter to 76.42%,64.80%,and 79.52% in the fourth quarter respectively,tendency chi-square test showed that difference was statistically significant (all P <0.05).The median of relative light unit (RLU)of hands of HCWs,object sur-faces,and cleaning tools were 20.00,85.00,and 35.00,respectively.Conclusion ATP fluorescence detection for on-site monitoring and supervision for cleaning and disinfection effect can promote the continuous quality improve-ment of hand hygiene and environmental cleanliness.

Objective To evaluate the impact of duration of preoperative smoking cessation on preventing postoperative pulmonary complications. Methods A literature search was conducted at PUBMED, Web of Science, Chinese National Knowledge Infrastructure (CNKI) database, and Wangfang database. Meta-analyses were conducted for randomized trials and observational studies on preoperative smoking cessation and postoperative pulmonary complications published in the period from the establishment of the database to July 2016.Results A total of 14 studies were included,involving 8 060 patients in the quitting group and 2 845 in the control group. Smokers who quit not less than four weeks before surgery had lower risk of complications than those who did not abstain till surgery or quit less than four weeks before surgery(RR 0.77;95%CI 0.68 to 0.88).Smokers who quit not less than eight weeks before surgery had lower risk of complications than those who did not abstain till surgery or quit less than eight weeks before surgery (RR 0.54; 95% CI 0.35 to 0.85). Conclusions Abstaining from smoking for at least four weeks before surgery reduces the risk of postoperative pulmonary complications. Abstaining from smoking for at least eight weeks also reduces the risk of postoperative pulmonary complications and is demonstrated to be more beneficial.

Objective: To explore the practice and effect of transparent supervision in the prevention and control of multidrug-resistant organism (MDRO). Methods: Transparent supervision was introduced to intervene into the MDRO management of monitored departments. Such transparent supervision was aided by IT means, and transparent MDRO control indexes. These indexes included hand hygiene compliance rate, qualification rate of ATP detection of environmental object surface, implementation rate of main MDRO prevention and control measures, MDRO resistance rate, and nosocomial infection incidence. The data before and after the intervention were compared by Chi square test to evaluation the effect. Results: After intervention, the hand hygiene compliance rate increased from 49.83% to 65.61% (χ²=47.389, P<0.001), and the qualification rate of ATP detection of environmental object surface increased from 48.50% to 83.33% (χ²=96.115, P<0.001). Meanwhile, such indexes as prescription of patient isolation, placement of isolation identifiers and that of specialized bedside equipments increased significantly(P<0.001). The MDRO detection rate decreased from 75.08% to 63.31% (χ²=28.123, P<0.001), and the incidence of nosocomial infection decreased from 4.77% to 3.47%(χ²=20.303, P<0.001). Conclusions The practice of transparent supervision could reduce the risk of MDRO transmission at hospitals effectively, proving its importance in ensuring medical quality and patient safety.

Objective: To study the clinical characteristics, strategy of treatment and prognosis of multiple primary cancers(MPC) diagnosed of digestive system malignant tumor firstly. Methods: From January, 2000 to December, 2015, the clinical, follow-up and prognostic data of 138 MPC patients diagnosed of digestive system malignant tumor firstly were retrospectively analyzed. Results: 138 cases were found in 10 580 cases with malignant tumors, and the incidence was 1.30%. There were 129 cases of duplex primary cancers, 8 cases of triple primary cancers and 1 case of quintuple primary cancers. The repetitive primary cancer was occurred in digestive system (61cases, 44.2%) most frequently, with the next in respiratory system (46 cases, 33.3%). 52.2% (72 cases) suffered second primary cancer in 2 years after first primary cancer diagnosed, and 75.4% (104 cases) in 5 years. The median overall survival in patients with all cancer lesions radically treated was 168 months, better than any other treatment (68 months, P<0.05). Conclusions The second primary cancers of MPC cases initially diagnosed of digestive system malignant tumor most frequently occurred in the digestive system and respiratory system. More concern should be attracted in follow-up, especially in the first 5 years. The key to improve patient′ prognosis was radical treatment to every primary cancer.